The place of philosophy in nursing.

Philosophy adds humanness to nursing and facilitates holistic care. Philosophies like Ubuntu which purports that a person is only a person through other people and emphasises community cohesion and caring for each other can add humanness to nursing. Because Ubuntu validates subjective experience and its meaning in the lifeworld, it exemplifies the basis of holistic and individualised caring in nursing. Although nurses can make their own philosophy through critical reflexivity, the convergent point is the goal of meaningful caring that is, sustaining health and the well-being of patients and significant others. Philosophy transcends job description, it encompasses visceral experience, personal beliefs and goals, resulting in purpose and deeper meaning to the nursing profession of caring as emulated by Florence Nightingale. While contemporary philosophy has been met with criticism as being detached from human concern, narrowly focussed and technical, it evokes critical thinking and promotes sociality in nursing practice. The Covid-19 pandemic vividly brought philosophy to the fore as nurses sacrificially and vulnerably rose to the challenge of caring not only for the sick, but also for families who through infection control measures were deprived of sociality. This paper argues that philosophy adds humanness and substance to nursing in the context of COVID-19.

The Holistic Theory of Unpleasant Symptoms.

This article describes a holistic revisioning of symptom theory for nursing practice. The Holistic Theory of Unpleasant Symptoms (HTOUS), informed by the Science of Unitary Human Beings, describes the complexity of symptom experience and how nursing actions can be associated with its transformation. Existing theories of unpleasant symptoms which broadly describe the antecedents, characteristics, and consequences of symptoms, have been reconceptualized from holistic and integral perspectives. Applying integral concepts such as human energy field and pattern manifestation expands understanding of both symptom experience and the nurse's response to it. Spirituality is an addition to symptom theory, being seen as a characteristic of Human Energy Field pattern manifestations. The theory's major concepts are symptom experience manifestations and wellbecoming manifestations. Concepts of the sustaining presence of the nurse and voluntary mutual patterning are explored. Pain, nausea, dyspnea, anxiety, despair, and other symptoms are discussed. Because HTOUS is acausal and nonlinear, it is widely applicable to creative, theory-directed nursing practice and research. Recommendations are made for practice, research, and further theory development.

Using Heidegger's philosophy of dasein to support person-centred research.

BACKGROUND: Locating and explicating philosophical frameworks, which enable a person-centred approach, is important for nurses undertaking research to respect and value participants during the process. This reflects the ideals of person-centred care. AIM: To explore how Heidegger's philosophical concept of dasein and its relationship with the hermeneutic circle can support person-centred research. DISCUSSION: Dasein is described as 'being in the world' and encourages thinking about the ways in which people are bound to their surroundings and history. Understanding and applying it to nursing research is important as it enables researchers to explore the 'lifeworld' of another and promotes person-centred research practice. CONCLUSION: Developing a person-centred approach to research can be achieved by using Heidegger's concept of dasein, which can enable the development of insight into another person's lifeworld. IMPLICATIONS FOR PRACTICE: Understanding the concept of dasein enables nurse researchers to undertake person-centred research. Dasein recognises individuals in the holistic context of their world and values what is important to them. Situating findings contextually allows nurse researchers to influence nursing practice and policy.

Divinity in nursing: The complexities of adopting a spiritual basis for care.

In this paper, the historical alignment of nursing with divinity-based perspectives and modern New Age nursing theories are explored. The nature of divinity in nursing is examined, together with the complexities and issues that arise in adopting a spiritual basis for care. The work of the key theorists in this area (Rogers, Newman, Parse, Watson, Dossey) is reconsidered and fundamental epistemological problems inherent in this approach reviewed. Specific concerns with the interpretation of holistic care, adoption of doxastic logic, faith-based rationales, influence of Caucasian Judeo-Christian and New Age values, misappropriation of science, use of pseudoscience and development of divinity as social consumer product are discussed. Practical problems with using a spiritual basis in contemporary nursing practice are also explored and the alignment of divinity-based nursing theories with the modern antiscience movement is examined. Overall, the re-emergence of divinity-based nursing and spiritual basis for care may be problematic, and would seem to counter the development of an inclusive profession. Additionally, the alignment of nursing with antiscience movements rejecting biomedicine has significant public health implications. This is argued as a regressive step for the advancement of the profession.

L'impératif cosmique universel : l'apport du modèle de Roy au savoir infirmier.

The contemporary challenge in the field of health is undeniably that of devising a way to integrate humans and the environment that is beneficial to health. This article presents the universal cosmic imperative (UCI) philosophical perspective and the notion of the cosmic imperative that leads human beings to be creative in their relationship to nature. It begins by consolidating the exegesis of the internal evolution of Roy’s theory and identifying its influences. The epistemological and philosophical postulates upon which Roy’s theory was built are specified, and then the evolution of Roy’s thought is described in three main phases. The article then moves on to describe and explain the epistemological openings that Roy’s theory allows from the point of view of current health issues, especially environmental medicine, in a macro-meso-micro perspective of global health. Roy’s thinking is part of the question of the current turning point in the discipline of nursing (cure-care-healing) and the definition of its focus. Roy’s theory resists current theoretical developments, which it allows us to describe and question in a pattern that is fruitful for researchers.

Epidurals during normal labour and birth - Midwives' attitudes and experiences.

BACKGROUND: Midwives have their own beliefs and values regarding pain during childbirth. Their preferences concerning labour pain management may influence women's choices. AIM: To gain a deeper understanding of midwives' attitudes and experiences regarding the use of an epidural during normal labour. METHODS: A qualitative approach was chosen for data collection. Ten in-depth interviews were conducted with midwives working in three different obstetric units in Norway. The transcribed interviews were analysed using Malterud's systematic text condensation. FINDINGS: The analysis provided two main themes: "Normal childbirth as the goal" and "Challenges to the practice, knowledge, philosophy and experience of midwives". Distinctive differences in experiences and attitudes were found. The workplace culture in the obstetric units affected the midwives' attitudes and their midwifery practice. How they attended to women with epidural also differed. An epidural was often used as a substitute for continuous support when the obstetric unit was busy. DISCUSSION: Midwives estimate labour pain differently, and this might impact the midwifery care. However, midwives' interests and preferences concerning labour pain management should not influence women's choices. Midwives are affected by the setting where they work, and research highlights that an epidural might lead to a focus on medical procedures instead of the normality of labour. CONCLUSION: Midwives should be aware of how powerful their position is and how the workplace culture might influence their attitudes. The focus should be on "working with" women to promote a normal birth process, even with an epidural.

The theory of caritative caring: Katie Eriksson's theory of caritative caring presented from a human science point of view.

The Finnish nursing theorist Katie Eriksson's (1943-2019) theory of caritative caring represents a non-medical paradigm concerning the phenomena of nursing. The aim of this article was to present an oversight of the development of Eriksson's theory of caritative caring from a human science point of view. The historical development of the theory is outlined, combined with a brief overview of its philosophical connections, its impact on contemporary caring science research and its implications for nursing care. Caring science is considered a human science in the Nordic tradition, as it is deeply rooted in basic issues of human life and existence. The key ideas of Eriksson's theory of caritative caring are linked to the metaparadigm concepts of human being, health and suffering, caring and environment. All of these are permeated with the ethos of caritative caring, that is, the caritas thought of human love and mercy, and the honouring of the absolute dignity of human beings. Epistemologically, Gadamer is the most influential philosopher when it comes to the theory of caritative caring. Eriksson's theory is used in, for example, intercultural caring, caring for patients suffering from addiction, the importance of aesthetic surroundings, providing ethically good care for older people and mothers as patients in psychiatric care. In these fields of research, Eriksson's ideas of ethics, caring and suffering are highlighted in various clinical contexts. Beyond the areas of nursing care in which Eriksson's work has been cited and developed, there are at least two areas that have been actively enhanced by her works: the field of leadership and education for nursing teachers. According to Eriksson, it is momentous to ponder scientific results as not limited to empirically strengthened, randomized outcomes. Part of making the results of scientific work evident is up to the individual nurses and their being in the world.

Facilitating and hindering experiences to the development of humanistic caring in the academic and clinical settings: an interpretive phenomenological study with nursing students and nurses.

Objectives This paper reports on nursing students' and nurses' lived experiences mediating their development of humanistic caring. Methods Using interpretive phenomenology, 26 participants were individually interviewed. A five-stage phenomenological analysis based on Benner's (Benner, P. (1994). Interpretive phenomenology: Embodiment, caring, and ethics in health and illness. Thousand Oaks, CA: SAGE) method occurred simultaneously. Results The analysis highlighted that the development of humanistic caring is affected by role models and counterexamples, environments in which humanistic caring is exalted or trivialized, communication-related courses, patient storytelling, and work overload. Conclusions It might be valuable to raise the awareness of nurse educators about their opportunity in shaping the development of students' humanistic caring.

As dimensões do ser humano e o cuidado de enfermagem no contexto pandêmico da COVID-19 / The dimensions of the human being and nursing care in the pandemic context of COVID-19 / Las dimensiones del cuidado del ser humano y de la enfermería en el contexto pandémico de COVID-19

Objetivo: refletir sobre as dimensões do ser humano e o cuidado de enfermagem no contexto pandêmico da Covid-19. Método: trata-se de um estudo reflexivo, em que foram discutidas as dimensões corpórea (Homo somaticus), de vida humana (Homo vivens), conhecer (Homo sapiens), vontade (Homo volens), linguagem (Homo loquens), social (Homo socialis), do trabalho (Homo faber), jogo e divertimento (Homo ludens) e o cuidado de enfermagem no contexto pandêmico da Covid-19. Resultados: as dimensões estão sendo influenciadas pelo contexto pandêmico do novo coronavírus, sendo necessárias intervenções de enfermagem humanizadoras como o manejo clínico e terapêutico transpessoal, suporte ao corpo físico em adoecimento, garantia de uma linguagem que possibilite o autocuidado e apoio psicológico, atitude de escuta aberta, incentivo às práticas de jogos para passar o tempo e métodos de relaxamento, meditação e imaginação guiada, entre outras. O ato de refletir sobre as dimensões cria novas possibilidades de sinalizar pontos de intercessão para a compreensão da nova realidade vivenciada pelo homem. Conclusão e implicações para a prática: ao refletir sobre as dimensões do homem à luz da antropologia com o embasamento teórico dos Modelos de cuidados da Nursing Interventions Classification (NIC), geram-se possibilidades de estabelecer um cuidado holístico no contexto da pandemia pelo novo coronavírus

Objective: to reflect on the dimensions of the human being and nursing care in the pandemic context of Covid-19. Method: this is a reflection study, in which the corporeal dimensions (Homo somaticus), human life (Homo vivens), knowing (Homo sapiens), will (Homo volens), language (Homo loquens), social (Homo socialis), work (Homo faber), play and fun (Homo ludens) and nursing care in the pandemic context of Covid-19. Results: the dimensions are being influenced by the pandemic context of the new coronavirus, requiring humanizing nursing interventions, such as transpersonal clinical and therapeutic management, support for the sick physical body, guarantee of a language that enables self-care and psychological support, attitude of open listening, encouraging game practices to spend time and methods of relaxation, meditation and guided imagination, among others. The act of reflecting on the dimensions creates new possibilities for signaling points of intercession for the understanding of the new reality experienced by man. Conclusion and implications for practice: when reflecting on the dimensions of man in the light of anthropology with the theoretical basis of the Nursing Interventions Classification (NIC) Care Models, possibilities for holistic care are created in the context of the new coronavirus pandemic

Objetivo: reflexionar sobre las dimensiones del ser humano y la atención de enfermería en el contexto pandémico de Covid-19. Método: este es un estudio reflexivo, en el que las dimensiones corporales (Homo somaticus), la vida humana (Homo vivens), el conocimiento (Homo sapiens), la voluntad (Homo volens), el lenguaje (Homo loquens), social (Homo socialis), trabajo (Homo faber), juego y diversión (Homo ludens) y cuidados de enfermería en el contexto pandémico de Covid-19. Resultados: las dimensiones están siendo influenciadas por el contexto pandémico del nuevo coronavirus, que requiere intervenciones humanizadoras de enfermería, como el manejo clínico y terapéutico transpersonal, el apoyo al cuerpo físico enfermo, la garantía de un lenguaje que permita el autocuidado y el apoyo psicológico, la actitud de escucha abierta, fomentando prácticas de juego para pasar el tiempo y métodos de relajación, meditación e imaginación guiada, entre otros. El acto de reflexionar sobre las dimensiones crea nuevas posibilidades para señalar puntos de intercesión para comprender la nueva realidad experimentada por el hombre. Conclusión e implicaciones para la práctica: reflexionar sobre las dimensiones del hombre a la luz de la antropología con la base teórica de los Modelos de Atención de la Clasificación de Intervenciones de Enfermería (NIC) genera posibilidades de atención integral en el contexto de la nueva pandemia de coronavirus

Albert Mieczyslaw Krapiec's theory of the person for professional nursing practice.

This article presents the works of great Polish philosopher, Mieczyslaw Albert Krapiec, whose creative output can be applied to professional nursing practice. Krapiec's philosophical heritage is extensive and encompasses many philosophical fields: metaphysics, philosophical anthropology, philosophy of law, philosophy of culture, philosophy of politics and philosophy of language. Krapiec created an original philosophical synthesis characterized by a realistic approach. In this paper, I present only one of several original philosophical concepts developed by Krapiec: the theory of the person based on seven essential characteristics, that is the ability for cognition, love, freedom, religion, legal subjectivity, completeness and dignity. I attempt to show how these personal characteristics correspond to various patient needs. I argue that the qualitative deficit of any personal characteristics indicated by Krapiec corresponds to a patient's real need that must be satisfied. I also stress that the skilful diagnosing of all-not only selected-qualitative deficits of characteristics can be defined as holistic care in the nursing profession.

Sentidos do cuidado para acadêmicos de enfermagem: contribuições heideggerianas para o ensino / Directions for nursing academics towards care: heideggerian contributions to education / Sentidos de la atención para universitarios de enfermería: contribuiciones de Heidegger a la enseñanza

Objetivo: desvelar os sentidos dos acadêmicos de enfermagem acerca do cuidado de enfermagem. Método: pesquisa de natureza qualitativa na abordagem fenomenológica pautada no referencial teórico, filosófico, metodológico de Martins Heidegger. Foram participantes 13 acadêmicos de enfermagem do último período de graduação em uma Faculdade de Enfermagem de uma Universidade da Zona da Mata Mineira, que nos meses de setembro de 2015 realizaram depoimentos em encontro empático sobre o cuidado de enfermagem. Resultado: da análise compreensiva emergiu as Unidades de significação: Se colocar no lugar do outro, dar amor, carinho e ver o paciente como um todo e Conhecer a teoria para poder colocar o cuidado em prática. Conclusão: desvelou-se a dicotomia entre o conhecimento teórico e a prática, bem como a importância de se transpor o cuidado técnico para um cuidado holístico/acolhedor e humanístico

Objective: The study's purpose has been to address the meanings of nursing care from the nursing students' viewpoint. Methods: Qualitative research in the phenomenological approach based on the theoretical, philosophical and methodological framework of Martins Heidegger. Participants were 12 nursing students attending the last graduation semester at a Nursing School of a University located in the countryside of the Minas Gerais State. The nursing students gave statements during an empathic meeting on nursing careover September 2015. Result: Based on the data comprehensive analysis, the Units of meaning came about as follows: Putting yourself in other's shoes, give love and affection; Seeing the patient as a whole; and, Knowing the theory to put care into practice. Conclusion: The dichotomy between theoretical and practical knowledge was revealed, as well as the importance of transposing technical care to holistic/welcoming and humanistic care

Objetivo: revelar los sentidos de los universitarios de Enfermería acerca de la atención en enfermería. Método: investigación de carácter cualitativo con aproximación fenomenológica guiada por el referencial teórico, filosófico, metodológico de Martins Heidegger. Participaron 13 universitarios de enfermería del último curso de una facultad de enfermería en una universidad en la Zona da Mata Mineira, en el mes de septiembre de 2015 se tomó sus testimonios en el encuentro empático sobre la atención de enfermería. Resultado: el análisis global reveló las unidades de significado: Ponerse en lugar de otro, dar amor, afecto y mirar al paciente en su conjunto, y conocer la teoría para poner en práctica el cuidado. Conclusión: ee desveló la dicotomía entre el conocimiento teórico y la práctica, así como la importancia de traspasar el cuidado técnico a un cuidado holístico/acogedor y humanístico

Empowered Holistic Nursing Education as the Philosophical Framework for an RN-BS Program: A Six-Year Impact Evaluation Study.

The educational structure of many nursing programs is largely monocultural, with a traditional pedagogy. Empowered holistic nursing education (EHNE) creates a learning environment with more cultural responsiveness and support for diverse classrooms. The aim of this study was to determine what impact the theory had on diversification. With EHNE the philosophical framework of a new RN-to-BSN program, student demographic data were collected, along with exit survey questions. A statistically significant increase was found in the diversification of the six cohorts. The EHNE shows potential as a programmatic framework for increasing diversification of the nursing profession.

Ampliando horizontes na interface Práticas Integrativas com Epistemologia do Sul / Ampliar horizontes en la interfaz Prácticas Integradoras con Epistemología del Sur / To Broadening Horizons in the Interface Integrative Practices with the Epistemology of the South

RESUMO Introdução: A Epistemologia do Sul valoriza a pluralidade e o diálogo entre os diversos saberes. Na saúde, valoriza as diversas práticas do cuidar, abrindo espaço para a inserção das Práticas Integrativas e Complementares. Objetivo: Refletir sobre a dimensão das Práticas Integrativas e Complementares para o cuidado de enfermagem sob perspectiva da Epistemologia do Sul. Métodos: Trata-se de um ensaio reflexivo acerca das Práticas Integrativas e Complementares, embasado no referencial teórico da Epistemologia do Sul. Estruturou-se quatro categorias reflexivas: Desvelando a Epistemologia do Sul; O caminhar histórico das Práticas Integrativas e Complementares; A Epistemologia do Sul e o transitar entre o saber popular e o saber científico no uso das plantas medicinais; e O entrelaço das Práticas Integrativas e Complementares com a enfermagem, frente à Epistemologia do Sul. Conclusão: As Práticas Integrativas e Complementares, sob o olhar da Epistemologia do Sul, é mais uma ferramenta utilizada no processo de trabalho do enfermeiro capaz de ampliar a assistência em saúde, com valorização de conhecimentos e das práticas de cuidado adotadas pelos usuários dos serviços(AU)

RESUMEN Introducción: La epistemología del Sur valora la pluralidad y el diálogo entre los diversos saberes. En la salud, valoriza las diversas prácticas del cuidar, abriendo espacio para la inserción de las Prácticas Integrativas y Complementarias. Objetivo: Reflexionar sobre la dimensión de las Prácticas Integrativas y Complementarias para el cuidado de enfermería bajo perspectiva de la epistemología del Sur. Métodos: Se trata de un ensayo reflexivo acerca de las Prácticas Integrativas y Complementarias, basadas en el referencial teórico de la epistemología del Sur. Se estructuraron cuatro categorías reflexivas: Desvelando la epistemología del Sur; El caminar histórico de las Prácticas Integrativas y Complementarias; La epistemología del Sur y el transitar entre el saber popular y el saber científico en el uso de las plantas medicinales; y el entrelazamiento de las Prácticas Integrativas y Complementarias con la enfermería, frente a la epistemología del Sur. Conclusiones: Las Prácticas Integrativas y Complementarias, bajo la mirada de la epistemología del Sur, son una herramienta utilizada en el proceso de trabajo del enfermero capaz de ampliar la asistencia en salud, con valorización de conocimientos y las prácticas de cuidado adoptadas por los usuarios de los servicios(AU)

ABSTRACT Introduction: The epistemology of the south values plurality and dialogue between the different instances of knowledge. In health, it values the various care practices, opening space for the inclusion of integrative and complementary practices. Objective: To reflect on the dimension of integrative and complementary practices for nursing care from the perspective of the epistemology of the south. Methods: This is a reflective essay about integrative and complementary practices, based on the theoretical reference of the epistemology of the south. Four reflexive categories were structured: unveiling the epistemology of the south, the historical evolution of integrative and complementary practices; the epistemology of the south and the transit between popular knowledge and scientific knowledge in the use of medicinal plants, and the intertwining of integrative and complementary practices with nursing compared to the epistemology of the south. Conclusions: The integrative and complementary practices, under the view of the epistemology of the south, are a tool used in the nurse's work process as being capable of extending health care, with the valorization of knowledge and care practices adopted by the users of services(AU)

Spiritual Knowing: Another Pattern of Knowing in the Discipline.

Fundamental patterns of knowing in nursing have historically served to clarify the substance and structure of the discipline, significantly contributing to nursing's body of knowledge. In this article, we continue the scholarly conversation on patterns of knowing in nursing by advancing spiritual knowing as a pattern of knowing that helps advance nursing's agenda toward universal well-being and critical during this time toward interdisciplinarity. Implications for nursing are explored in relation to enduring and new questions that require our attention related to human beings, their environments, and healing.

"It's what midwifery is all about": Western Australian midwives' experiences of being 'with woman' during labour and birth in the known midwife model.

BACKGROUND: The phenomenon of being 'with woman' is fundamental to midwifery as it underpins its philosophy, relationships and practices. There is an identified gap in knowledge around the 'with woman' phenomenon from the perspective of midwives providing care in a variety of contexts. As such, the aim of this study was to explore the experiences of being 'with woman' during labour and birth from the perspective of midwives' working in a model where care is provided by a known midwife. METHODS: A descriptive phenomenological design was employed with ten midwives working in a 'known midwife' model who described their experiences of being 'with woman' during labour and birth. The method was informed by Husserlian philosophy which seeks to explore the same phenomenon through rich descriptions by individuals revealing commonalities of the experience. RESULTS: Five themes emerged 1) Building relationships; 2) Woman centred care; 3) Impact on the midwife; 4) Impact on the woman; and 5) Challenges in the Known Midwife model. Midwives emphasised the importance of trusting relationships while being 'with woman', confirming that this relationship extends beyond the woman - midwife relationship to include the woman's support people and family. Being 'with woman' during labour and birth in the context of the relationship facilitates woman-centred care. Being 'with woman' influences midwives, and, it is noted, the women that midwives are working with. Finally, challenges that impact being 'with woman' in the known midwife model are shared by midwives. CONCLUSIONS: Findings offer valuable insight into midwives' experiences of being 'with woman' in the context of models that provide care by a known midwife. In this model, the trusting relationship is the conduit for being 'with woman' which influences the midwife, the profession of midwifery, as well as women and their families. Descriptions of challenges to being 'with woman' provide opportunities for professional development and service review. Rich descriptions from the unique voice of midwives, provided insight into the applied practices of being 'with woman' in a known midwife model which adds important knowledge concerning a phenomenon so deeply embedded in the philosophy and practices of the profession of midwifery.

A Synopsis of Ricoeur's Phenomenology of the Will: Implications for Nursing Practice, Research, and Education.

The will is a word that nurses may use to describe their patients' actions or inactions. This concept has been extensively addressed by religions, psychologists, and philosophers. Ricoeur offered a phenomenology of the will in which three overarching key concepts were uncovered: decision, action, and consent. In this article, Ricoeur's elaborative and exhaustive description of these three concepts is summarized. Examples as to how a phenomenology of the will may guide nurses in their day-to-day clinical practice in caring are provided. In research, Ricoeur's phenomenology of the will may be used as a heuristic to guide phenomenological studies. An introduction to the will may act as a bridge between the art and science of nursing, providing nursing students with a greater understanding of the meaning of and need to provide holistic care.

Concept development in Nursing and Midwifery: An overview of methodological approaches.

BACKGROUND: Over the past four decades, there has been a growing focus on the resolution of conceptual problems through the process of concept development. As the focus on this area has grown, so too has the number of debates in the literature on methodological aspects of concept development. AIM: To provide an overview of the essential methodological considerations of concept development. DESIGN: Discussion paper. An overview is presented of the methodological considerations of commonly used concept development strategies and methods within nursing and midwifery. DATA SOURCES: Literature dating from the inception of concept development in nursing and midwifery. IMPLICATIONS FOR NURSING AND MIDWIFERY: The robust development of concepts is a vital component in advancing the knowledge base of nursing and midwifery theory and practice. However, the complexity of the concept development literature may serve to exacerbate the challenges of developing a given concept, in particular for the novice researcher. CONCLUSION: The methodological considerations discussed provides guidance in determining the most appropriate strategy and method of concept development.